HomeMy WebLinkAboutCertificate of Compliance - 75 SHERWOOD DRIVE 5/12/2000 TOWN OF NORTH ANDOVER
BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
DATE OF COMPLIANCE:
5/12/00
This is to certify that
the individual subsurface disposal system
constructed (X) or repaired ()
by
Ray Fraser
at
Lot 15 Sherwood Drive
has been installed in accordance with the provisions of Title V of the State Sanitary Code
and with the North Andover Board of Health regulations.
The Issuance of this certificate shall not be construed as a guarantee that the system will
function satisfactorily.
Board of Health Inspector
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05/05/00 3-8-34 5007748148 THE FR.ASER COMPANY PAGE 01
TOWN OF NORTH ANDOVER SEWAGE WSPOSAL SYSTUNi
IN'S`IIA LATION CERTIFICATION
The ustdtrsigned hereby certify that the Sewage Disposal System k-11 constructed;
l ) repaired:
locitted at
was installed in cvrilorrrrance with the North Andover Board of Health approved pliut,
System Design 1'cr-mit d d
# �� ate t� �. �
�=--' -,---��---=�„�,�..�_.�......., with an approved design
flow ai Ak gallant,per day. The materials used were in cL)nzbrmance with those
spe�;rlirel o11 the appro'"d plan; the system was installed in accordance with the provisions
of a 10 C M 15.Cii1C, 'Title 5 and local regulations, and the luxai grading agrees
substantially with the approved plan. M work is accurately represented At1 the As.built
which has been submitted to the Boa;d of Health.
Bi;d in pertiorl date:
Engineer Representative
Final inspcCLion date:
Engineer RepresentattA e
lrtstdller. Lic.#; _ Date: s
Design Engineer: �/c� �N.,"„
Date: 5''41"a6
AS-BUILT CHECKLIST
LOT NUMBER, STREET NAME
ASSESSORS MAP & PARCEL NUMBER
LOT LINES & LOCATION OF DWELLINGS
LOCATION & DEMENSIONS OF SYSTEM,
INCLUDING RESERVE
TIES TO LOT LINES & DWELLING, WELLS
a, FROM SEPTIC TANK
b. FROM LEACH AREA
LOCATIONS OF DEEP HOLES & PERC
TESTS
ELEVATION OF
/_. S DISPOSAL 0 AL
✓ TOP OF FDN ELEVATION
LOCATIONS OF WELLS, DRAINS, WATERCOURSES
W/IN 150' OF SYSTEM
V/ LOCATION OF WATER, GA9, ELECTRIC LINES, CABLE
DISTANCES FROM CORNERS OF HOUSE TO CENTER OF
TANK & D-BOX
STAMP& SIGNATURE
IMPERVIOUS AREAS - DRIVEWAYS, ETC.
NORTH ARROW
FINAL CONTOURS
LOCATION & ELEVATION OF BENCHMARK USED
a_ LOCUSPLAN
a 0044. �Grl�l